Individual
DR. JAY MICHAEL JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7203 HODGSON MEMORIAL DR STE A, SAVANNAH, GA 31406-1525
(912) 352-9356
(912) 352-9105
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
743071437A
—
GA
Enumeration date
01/25/2007
Last updated
07/10/2024
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